![]() Most patients often describe a pain in the groin or thigh several weeks or even months before the fracture. They are noncomminuted complete fractures with transverse or short oblique orientation or incomplete manifested with a radiolucent line within the lateral cortex and are related with low energy trauma or no trauma at all. According to the ASBMR Task Force paper in 2010, the most common location of the atypical femoral fractures is the proximal one-third of the femoral shaft, but they can also occur anywhere along the diaphysis of the femur from just distal to the lesser trochanter to just proximal to the supracondylar flare of the distal femoral diaphysis. On the other hand, other studies suggest that there is no increase in atypical fractures in bisphosphonate users. in 2012, suggested that the risk for atypical femoral fractures is 1,78/100.000 person-years in patients receiving bisphosphonates for 6-8 years. However, many cases of atypical femoral fractures have been described after long-term use of bisphosphonates. Bisphosphonates are also indicated in osteoporotic men with great fracture risk. Their effectiveness is indicated by reports that demonstrate up to 50% reduction of vertebral fracture risk and 20-50% of femoral neck fracture risk. Therapy with most bisphosphonates has shown to reduce the risk of vertebral, non-vertebral and hip fractures in women with postmenopausal osteoporosis and are often considered to be the first choice of treatment. That can lead to disability, poor quality of life and mortality. Osteoporosis is a common disease in the elderly, associated with a great fracture risk. Key wordsīisphosphonates, atypical femoral fracture, osteoporosis treatment Introduction Treatment consisted of discontinuation of bisphosphonates, intra-medullary nailing of the right femur and conservative treatment of the left side. Thus, our patient had a complete fracture on the right side and an incomplete one, represented by lateral cortex thickening on the left. Her past medical history of osteoporosis treated with alendronate for six years along with symptoms in the contra-lateral thigh for the past 2 years, lead to imaging of the left femur. In this paper we report the case of a 75-year-old woman who sustained an atypical right femur fracture while walking. They are related to minimal, or no trauma at all, but symptoms do pre-exist long before the gross fracture actually takes place. Their morphology is simple, transverse or short oblique. They usually occur in the proximal third of the femur, and may be complete or incomplete, manifesting either like a radiolucent line or just thickening of the lateral cortex. These have a characteristic pattern and history. Nevertheless, long term bisphosphonate use has been linked with atypical femur fractures. Bisphosphonates are efficient and have been widely used in the treatment of osteoporosis. It would have been nice to know this before we started it.Osteoporosis is a common disease in the elderly, correlated with increased fracture risk, disability and mortality. I’m not sure about the medical field these days but I will talk to him about a scan to see if they can tell me the likelihood of a fracture. When I mentioned the rebound effect he said “don’t worry, many people have stopped it with no problems”. ![]() ![]() I’ve been taking a calcium tablet and I go back to the Onc in January. Staying on or coming off it’s the same problem. Now so far the cancer has stayed in my bones which might be due to Xgeva but the “rebound effect” as they call it seems to have no answer. I watched a doctor on you tube referring to it as a “dangerous drug”. I’ve now got a pain in my jaw so hoping it’s not the start of ostenecrosis. If you can take a bisophonate that might help but it also has the same problems with fractures after a time. My last shot was July and now I’m trying to dial down the panic as there is no way off this drug. Uveitis specialist in Portland Oregon who ran many tests and concluded it was the Xgeva. Lost partial sight in my left eye then the same was happening on my right eye. ![]()
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